Doctors in the Death Chamber?

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AP Photo A badly botched lethal injection has put a slew of capital punishment cases on hold. The Daily Beast's Ben Crair reports on how physicians could help make executions more humane.

On September 15, for only the second known time in American history, a death-row inmate exited from an execution chamber alive. Prisoner 187 343, a convicted murderer and rapist named Romell Broom, had his sentence temporarily reprieved by Ohio Governor Ted Strickland, but only after enduring what Fordham Law Professor Deborah Denno, a death-penalty historian, calls “the worst botched execution that has happened in the history of this country.” Over two-and-a-half hours, executioners jabbed Broom with a needle 18 times, trying to establish an IV while he cried. At one point, Broom screamed as a nurse inserted a needle into the bone in his ankle; at another juncture, Broom helped to tie his own arm. Unable to establish access to a vein, officials offered Broom coffee and a cigarette while his arms bruised and swelled. Half an hour later, his execution was postponed.

“The problem with lethal injection is that if medically underqualified people do it, it’s immoral because of the risk of torture,” says Jonathan Groner, a professor of clinical surgery at Ohio State College of Medicine. “And if medically well-qualified people do it, it causes doctors to violate their ethics.”

It was not Ohio’s first trouble with lethal injection. In May 2006, Joseph Clark lifted his head during an 86-minute execution to cry, “It don’t work.” A year later, in 2007, Christopher Newton’s execution took so long that he was permitted a bathroom break in the middle of the ordeal. When Newton eventually died, witnesses said his hands and forehead turned blue—a sign that he died from suffocation induced by the second of the three drugs instead of cardiac arrest from the third drug, as he was supposed to. In all three cases, the executions were administered by EMTs—professionals who lack the experience doctors have in hooking up IVs. Broom’s case is headed to court—his execution, originally rescheduled for one week later, is now on hold—and Ohio has begun delaying others in its wake; the fourth postponement since the Broom episode was announced Monday. In this climate, death-row activists and lawyers are hoping to draw attention to the undertrained staff tasked with carrying out inmates’ sentences. Undoubtedly, Broom and dozens of other death-row inmates across the country would suffer less if doctors aided in their executions. Does that mean they should?

“I’m sure I could have gotten an IV into Broom, Clark, or Newton,” says Jonathan Groner, professor of clinical surgery at the Ohio State College of Medicine. “That’s not particularly special. Vascular access is what we do for a living.” Groner, however, refuses to participate in executions; as a doctor, he is morally opposed. The American Medical Association claims that physician participation in executions “violates their oath to protect lives and erodes public confidence in the medical profession;” the group prohibits its members from even “consulting with … lethal-injection personnel.”

Groner calls the problem the Hippocratic Paradox. “The problem with lethal injection is that if medically underqualified people do it, it’s immoral because of the risk of torture,” he says, “and if medically well-qualified people do it, it causes doctors to violate their ethics”—an outcome Groner says could damage the entire medical profession by putting doctors at the service of the state, instead of the individual.

The Supreme Court cited the AMA’s opposition in its 2008 ruling upholding lethal injection’s constitutionality, arguing that a requirement for physician participation would lead to a de facto moratorium on executions. Their ruling ignored the fact that, contrary to popular belief, not only can doctors participate in executions, but that some already do participate in executions. The AMA’s ethical guidelines are not legally binding, and only about 20 percent of doctors are members. State medical boards can punish doctors who participate, but to this day, no doctor has ever lost his license for taking part in a lethal injection. (If the AMA found one of its members to be participating in lethal injections, that member would face revocation of his membership and could be referred to his state’s medical licensing board or another legal authority.)

The extent and nature of doctor participation is unclear in part because of the lengths states go to in order to protect their execution protocols. Only two states—Illinois and Kentucky—prohibit doctors from taking part in executions, while 15 actually require it. A 2001 survey of physicians found that 41 percent were willing to perform at least one of the AMA’s eight discouraged lethal-injection actions. Twenty-five percent were willing to perform at least five, and 19 percent were willing to administer the lethal drugs.

These willing executioners are not necessarily wannabe Mengeles. In 2006, Atul Gawande tracked down four physicians who had assisted in executions. One doctor originally signed up for cardiac monitoring, but soon found himself inserting IVs when the technicians were unable to do so. Another doctor, Carlo Musso of Georgia, described his participation thusly, “The way I saw it, this is an end-of-life issue, just as with any other terminal disease. … When we have a patient who can no longer survive his illness, we as physicians must ensure he has comfort.”

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October 23, 2009 | 12:30am

Execution Chamber, Romell Broom, Death Row, Deborah Denno, Harvard Children's Hospital, David Waisel, University Of California At Berkeley, Death Penalty Clinic, Ty Alper, Carlo Musso, Ohio State College Of Medicine, Jonathan Groner, Christopher Newton, Joseph Clark, American Medical Association, Atul Gawande, Supreme Court

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AngryJ

I cannot believe what I am hearing. A convicted rapist and murderer was "tortured" by receiving a bunch of sticks with an IV needle. BS, I say we give the victims family a choice. They can take a metal baseball bat and end the life of this evil person however they wish, or they can let somebody else end his horrid existence humanely, an option not afforded his victim. I don't care if they stuck his hundred times, he deserves to die. I wish you whiny liberals would grow a pair and do what is necessary, quit trying so hard to be so nice to such evil people.

BTW, I am offering my services to end evil scum like this, no matter how many times I have to try.

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Doctors in the Death Chamber?

Doctors in the Death Chamber?